U.S. patent application number 14/358928 was filed with the patent office on 2014-10-02 for laryngoscope and laryngoscope blades.
The applicant listed for this patent is AIRCRAFT MEDICAL LIMITED. Invention is credited to Peter Douglas Colin Inglis, Matthew John Ross McGrath, Thomas James Rhodes.
Application Number | 20140296645 14/358928 |
Document ID | / |
Family ID | 45444238 |
Filed Date | 2014-10-02 |
United States Patent
Application |
20140296645 |
Kind Code |
A1 |
McGrath; Matthew John Ross ;
et al. |
October 2, 2014 |
LARYNGOSCOPE AND LARYNGOSCOPE BLADES
Abstract
A laryngoscope body for use with laryngoscope blades is
presented having an elongate handle and a blade retaining member
configured to retain a blade such that the blade extends away from
the elongate handle; wherein the blade retaining member is fixable
at a plurality of positions to allow a blade to be retained on the
blade retaining member at a plurality of--angles relative to the
elongate handle. There is also disclosed a kit of parts comprising
a laryngoscope body and a plurality of blades, as well as a method
of use for the said laryngoscope body with a suitable laryngoscope
blade.
Inventors: |
McGrath; Matthew John Ross;
(Edinburgh, GB) ; Inglis; Peter Douglas Colin;
(Edinburgh, GB) ; Rhodes; Thomas James;
(Edinburgh, GB) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
AIRCRAFT MEDICAL LIMITED |
Edinburgh |
|
GB |
|
|
Family ID: |
45444238 |
Appl. No.: |
14/358928 |
Filed: |
November 16, 2012 |
PCT Filed: |
November 16, 2012 |
PCT NO: |
PCT/GB2012/052858 |
371 Date: |
May 16, 2014 |
Current U.S.
Class: |
600/186 ;
600/193; 600/196 |
Current CPC
Class: |
A61B 1/00101 20130101;
A61B 90/90 20160201; A61B 1/267 20130101; A61B 1/00147
20130101 |
Class at
Publication: |
600/186 ;
600/196; 600/193 |
International
Class: |
A61B 1/267 20060101
A61B001/267; A61B 19/00 20060101 A61B019/00 |
Foreign Application Data
Date |
Code |
Application Number |
Nov 16, 2011 |
GB |
1119797.7 |
Claims
1. A laryngoscope body comprising an elongate handle and a blade
retaining member configured to retain a blade such that the blade
extends away from the elongate handle; wherein the orientation of
the blade retaining member is variable to allow a blade to be
retained on the blade retaining member at a plurality of angles
relative to the elongate handle.
2. A laryngoscope body according to claim 1, wherein the blade
retaining member defines the angle at which a blade retained on the
blade retaining member extends from the handle.
3. A laryngoscope body according to claim 1, wherein the blade
retaining member comprises an elongate member for slidably
retaining a blade having a cooperating channel.
4. A laryngoscope body according to claim 1, wherein the blade
retaining member is selectively deployable in a plurality of
configurations in which in which the exit angle is restricted at
least to the extent of limiting the maximum exit angle, wherein the
maximum exit angle is different in each of the plurality of
configurations.
5. A laryngoscope body according to claim 1, wherein the blade
retaining member is selectively fixable in one, or a plurality of
positions.
6. A laryngoscope body according to claim 5, wherein the blade
retaining member is selectively fixable in a first position having
a first exit angle, or has the maximum exit angle fixed at a first
exit angle, suitable for use with a first blade having an inferior
surface with a first curvature, and is also selectively fixable at
a second position having a second exit angle, or having the maximum
exit angle fixed at a second exit angle, which is greater than the
first exit angle, suitable for use with a second blade having a
inferior surface of with a second curvature which is greater than
the first curvature.
7. A laryngoscope body according to claim 6, wherein the exit
angle, or the maximum exit angle, is between 120 and 140 degrees in
the first position.
8. A laryngoscope body according to claim 6, wherein the exit
angle, or the maximum exit angle, is between 140 and 180
degrees.
9. A laryngoscope body according to claim 1, wherein the exit angle
is adjustable to at least, or greater than 180 degrees and cannot
be fixed beyond a maximum fixing exit angle.
10. A laryngoscope body according to claim 1, comprising a biasing
mechanism to bias the exit angle between the blade retaining member
and the handle.
11. A laryngoscope body according to claim 1, comprising a locking
mechanism to lock the exit angle of the blade retaining member.
12. A laryngoscope body according to claim 1, wherein the
laryngoscope comprises a resilient cover which extends at least
over the flexible junction between the handle and the blade
retaining member.
13. A laryngoscope body according to 1, wherein the laryngoscope
body comprises a blade recognition element operable to recognise
which type of blade is retained on the blade retaining member.
14. A laryngoscope body according to claim 13, wherein the
laryngoscope body is configured to indicate to a user whether a
blade retained by the blade retaining member is suitable for use in
the current position of the blade retaining member upon recognition
of the retained blade by the blade recognition element.
15. A laryngoscope body according to claim 13, wherein the
laryngoscope body is configured to prevent use of a retained blade
that is not suitable for use in the current position of the blade
retaining member upon recognition of the retained blade by the
blade recognition element.
16. A laryngoscope body according to claim 1, wherein the blade
retaining member is movable automatically from a first position to
a second position automatically.
17. A laryngoscope blade comprising a mounting element for mounting
the laryngoscope blade to a blade retaining member and an
electronically readable storage medium operable to store
information relating to the type of the laryngoscope blade wherein
the electronically readable storage medium is readable by the blade
recognition element of the laryngoscope body according to claim
13.
18. A laryngoscope blade according to claim 17, wherein the
electronically readable storage medium is a radio frequency
identification tag.
19. A laryngoscope blade according to claim 17, wherein the
information relating to the type of the laryngoscope blade is
indicative of the curvature of the inferior surface of the
laryngoscope blade.
20. A laryngoscope blade according to claim 17, wherein the
mounting element is an elongate channel.
21. A kit of parts comprising a laryngoscope body according to
claim 13, and a plurality of laryngoscope blades which comprise a
mounting element for mounting the laryngoscope blade to the blade
retaining member and an electronically readable storage medium
operable to store information relating to the type of the
laryngoscope blade, wherein the electronically readable storage
medium of the laryngoscope blade is readable by the blade
recognition element of the laryngoscope body, and wherein the
plurality of laryngoscope blades comprises at least one
laryngoscope blade having an inferior surface with a first
curvature, and at least one laryngoscope blade having an inferior
surface with a second curvature which is different to the first
curvature.
22. A kit according to claim 21, wherein the at least one
laryngoscope blade having an inferior surface with a first
curvature is a direct view blade.
23. A kit according to claim 21, wherein the at least one
laryngoscope blade having an inferior surface with a second
curvature which is different to the first curvature is an indirect
view blade.
24. A kit according to claim 23, wherein the at least one
laryngoscope blade having an inferior surface with a second
curvature is not suitable for use to directly view the larynx of a
patient.
25. A kit according to claim 21, wherein the first curvature
differs from the second curvature by at least 10 degrees.
26. A laryngoscope comprising a laryngoscope body according to
claim 1, wherein the blade retaining member retains a blade, the
blade extending away from the elongate handle, wherein the
orientation of the blade retaining member is variable to vary the
exit angle between the blade retaining member and the handle.
27. Apparatus comprising a laryngoscope body according to claim 1
and a plurality of blades, each blade in the plurality of blades
comprising a mounting element for mounting the laryngoscope blade
to the blade retaining member, the plurality of blades comprising a
first blade having an inferior surface with a first curvature, and
a second blade having an inferior surface with a second curvature
which is different to the first curvature.
28. Apparatus according to claim 27, wherein the blade retaining
member comprises an elongate member for slidably retaining a blade
having a cooperating channel, the elongate member is fixable at a
plurality of angles relative to the elongate handle and each of the
blades within the plurality of blades comprise a said channel to
receive the blade retaining member; the plurality of blades
comprising two blades having inferior surfaces with a different
curvature adjacent to the channel of each blade.
29. A method of using a laryngoscope comprising the steps of;
providing a laryngoscope body according to claim 1, a first blade
and a second blade; fixing the blade retaining formation in a first
position having a first exit angle or deploying the blade retaining
formation in a first configuration in which in which the exit angle
is limited to a first maximum exit angle; mounting the first blade
to the blade retaining formation of the laryngoscope body; using
the laryngoscope body and first blade; demounting the first blade;
fixing the blade retaining formation in a second position having a
second exit angle which is different to the first exit angle, or
deploying the blade retaining formation in a second configuration
in which the exit angle is limited to a second maximum exit angle,
which is different to the first maximum exit angle; mounting the
second blade to the blade retaining formation; and using the
laryngoscope body and second blade.
30. A method of using a laryngoscope comprising the steps of:
providing a laryngoscope body according to claim 1 and a blade
which comprise a mounting element for mounting the laryngoscope
blade to the blade retaining member and an electronically readable
storage medium operable to store information relating to the type
of the laryngoscope blade, wherein the electronically readable
storage medium of the laryngoscope blade is readable by the blade
recognition element of the laryngoscope body; fixing the blade
retaining member of the laryngoscope body in a first position
having a first exit angle or deploying the blade retaining member
in a first configuration having a first maximum exit angle;
mounting the blade to the blade retaining member of the
laryngoscope body; inserting the blade into the oral cavity of a
patient; fixing the blade retaining member of the laryngoscope body
to a second position having a second exit angle which is different
to the first exit angle or deploying the blade retaining member in
a second configuration having a second maximum exit angle which is
different to the second exit angle; and viewing the oral cavity, or
a portion of the oral cavity of the patient.
31. A method according to claim 29, wherein the first blade is a
direct view blade and the second blade is an indirect view blade,
and the second exit angle or maximum exit angle is greater than the
first exit angle or first maximum exit angle; or wherein the first
blade is an indirect view blade, and the second blade is a direct
view blade, and the second exit angle or maximum exit angle is less
than the first exit angle or first maximum exit angle.
32. A method according to claim 30, wherein the first blade is a
direct view blade and the second blade is an indirect view blade,
and the second exit angle or maximum exit angle is greater than the
first exit angle or first maximum exit angle; or wherein the first
blade is an indirect view blade, and the second blade is a direct
view blade, and the second exit angle or maximum exit angle is less
than the first exit angle or first maximum exit angle.
33. A kit of parts according to claim 21, wherein the
electronically readable storage medium is a radio frequency
identification tag.
34. A kit of parts according to claim 21, wherein the information
relating to the type of the laryngoscope blade is indicative of the
curvature of the inferior surface of the laryngoscope blade.
35. A kit of parts according to claim 21, wherein the mounting
element is an elongate channel.
36. A kit of parts according to claim 21, wherein the first blade
is a direct view blade and the second blade is an indirect view
blade, and the second exit angle or maximum exit angle is greater
than the first exit angle or first maximum exit angle; or wherein
the first blade is an indirect view blade, and the second blade is
a direct view blade, and the second exit angle or maximum exit
angle is less than the first exit angle or first maximum exit
angle.
37. A method according to claim 30, wherein the electronically
readable storage medium is a radio frequency identification
tag.
38. A method according to claim 30, wherein the information
relating to the type of the laryngoscope blade is indicative of the
curvature of the inferior surface of the laryngoscope blade.
39. A method according to claim 30, wherein the mounting element is
an elongate channel.
Description
FIELD OF THE INVENTION
[0001] The invention relates to the field of laryngoscopes and
video laryngoscopes. Some embodiments of the invention relate to
video laryngoscopes including an elongate blade retaining member
comprising a video camera and configured to slidably receive a
removable blade having a cooperating channel in use.
BACKGROUND TO THE INVENTION
[0002] Laryngoscopes are medical devices in common use in oral and
tracheal medical procedures, and may be used to obtain view of the
glottis or larynx, or to manipulate the tongue, glottis or larynx
in order to facilitate insertion of endotracheal tubes or other
instruments such as endoscopes, which may be separate pieces of
equipment, or may be integral to a laryngoscope.
[0003] A laryngoscope typically comprises a body and a blade, which
is an elongate section which extends towards and into a patient's
oral cavity during a medical procedure such as intubation. A
laryngoscope blade may be integrally formed with the body, or
demountable. The laryngoscope body typically comprises a handle.
Demountable blades can be removed after use and either disposed of
or decontaminated for reuse. Single use demountable blades can be
particularly useful to avoid cross-contamination.
[0004] Some known laryngoscope blades, such as Miller or Wisconsin
blades, are substantially flat. However, the blade of a
laryngoscope is more commonly bent to better enter through a
patient's oropharynx towards their larynx. For example, the most
common curvature of a blade is what is commonly called the
Macintosh curve. The curvature is relatively gentle and when
inserted into a patient's oral cavity, allows a direct view of the
patient's larynx in normal situations. Such blades are referred to
herein as direct view blades.
[0005] However, where there are anomalies within the oral cavity of
the patient, or where an effective view of the larynx cannot be
achieved with a direct view blade, for example, it is often
necessary to use a blade with a greater curvature to allow the
blade to be inserted into the oral cavity around any obstructions.
In that case, a user cannot normally obtain a direct line of sight
view of the larynx and such blades are referred to herein as
indirect view blades. In the case of a video laryngoscope, a camera
is used to view the region around the trachea during an operation,
for example. Video laryngoscopy is especially useful with more
curved blades where an indirect view is required.
[0006] Currently it is necessary to provide a separate laryngoscope
for each situation, or, where disposable or replaceable blades are
used, blades must be chosen to suit the situation at hand. Changing
blades can be time consuming and the desired blade type may not be
available.
[0007] Accordingly, it is one object of the invention to provide a
laryngoscope that may be effectively used with blades of different
curvatures, for example, both direct view blades having a curvature
sufficiently gentle to enable a direct view and indirect view
blades which have a greater curvature and are configured to obtain
an indirect view of the larynx. Some embodiments may also employ
moderately curved blades which may be used to obtain either a
direct or indirect view.
[0008] Some embodiments of the invention address the problem of
avoiding unwanted chest interaction which can occur when a
laryngoscope is introduced to a patient. For example, when an
indirect view blade is introduced into a patient there can be
problems with the handle of the laryngoscope contacting the
patient's chest.
[0009] Additionally, since laryngoscope procedures may require some
forceful manipulation of the laryngoscope, it is additionally
desirable that the blade and the medical instrument as a whole, be
both light weight and mechanically robust. Thus, whereas it is
possible to produce robust blades, strength may be at the expense
of weight and blade dimensions may require to be larger than
optimal. Whereas it has been possible to produce comparatively
slimline blades, this has been at the expense of rigidity,
durability or suitability for certain procedures and it is known
for disposable laryngoscope blades to be either prone to cracking
during use, requiring replacement of the disposable portion, or
worse resulting in injury or increased risk of infection, or to be
sufficiently large as to be difficult to work with. Furthermore, if
the blade bends too much under excessive force, the view of the
larynx may be compromised.
[0010] It is known from EP 1638451 (McGrath) to provide a
laryngoscope comprising an elongate member onto which a blade
having an elongate channel can be demountably fitted. This elongate
member may function as a strengthening element, providing
additional mechanical strength to the blade and may comprise a
camera and/or light source, for example. However, it is not
apparent how such a device could be used with both direct and
indirect view blades as if the elongate member was oriented at the
correct angle for a direct view blade, one would anticipate that a
more curved indirect view blade fitted onto the same elongate
member would have its tip in the wrong place.
[0011] Accordingly, some aspects of the invention concern
laryngoscopes including elongate blade retaining members which are
usable with both direct view blades (for example those following
the Macintosh curve) and indirect view blades.
[0012] Some embodiments of the invention also address the problem
that as users of laryngoscopes will often not fit their own blades,
some users may not know the type or size of blade fitted to a
laryngoscope which is usable with blade of multiple shapes and
sizes.
SUMMARY OF THE INVENTION
[0013] Within this specification and the appended claims, the
inferior surface is the surface of a laryngoscope blade which faces
the patient's tongue in use.
[0014] The opposite surface is referred to as the superior surface.
Words such as interior, inferiorly, superior and superiorly are
used in corresponding senses.
[0015] The words distal and distally refer to being towards the end
of the blade which extends towards a patient's trachea in use and
the words proximal and proximally refer to being towards the person
carrying out the medical procedure, in use.
[0016] According to a first aspect of the invention there is
provided a laryngoscope body comprising an elongate handle and a
blade retaining member configured to retain a blade such that the
blade extends away from the elongate handle; wherein the
orientation of the blade retaining member is variable to allow a
blade to be retained on the blade retaining member at a plurality
of angles relative to the elongate handle.
[0017] Typically, during intubation procedures, a standard fixed
laryngoscope is used, which is generally designed for use with a
specific laryngoscope blade. Where the intubation procedure
requires the use of a blade with a higher curvature, in situations
where the patient's airway is obstructed for example, the distal
tip of the blade will extend towards the handle of the laryngoscope
such that during use the handle will come into contact with the
patient's chest. This leads to potential damage to the patient or
to the intubation procedure being more difficult to carry out
successfully.
[0018] The provision of a laryngoscope body having a blade
retaining member that can be moved between (and typically fixed at)
a plurality of orientations relative to the handle allows the blade
retaining member to be oriented at a greater interior angle
relative to the handle when using a blade having greater curvature
whilst allowing the distal tip of a blade of greater curvature to
be sufficiently far from the chest of the patient that intubation
can proceed without the handle of the laryngoscope contacting the
patient's chest. Therefore, the intubation procedure may be carried
out faster or more efficiently than if the laryngoscope itself was
required to be changed, and allows the medical practitioner
carrying out the procedure to adjust the angle of the blade
retaining member as needed.
[0019] Preferably, the blade retaining member defines the angle at
which a blade retained on the blade retaining member extends from
the handle. For example, it might comprise a formation onto which a
blade is received (typically, slidably received) to both
demountably retain the blade and define the angle at which the
blade extends from the handle.
[0020] Preferably, the blade retaining member comprises an elongate
member for slidably retaining a blade having a cooperating channel.
Typically, the elongate member is rotatably mounted on the elongate
handle. An elongate member can both retain a blade and define the
angle at which a blade extends from the handle. The elongate member
is typically rotatable relative to the elongate handle within a
plane. Typically, the elongate member is pivotable about a pivot
mounting on the elongate handle within a single plane.
[0021] The angle between the centre line of the elongate handle and
the centre line of the path along which the blade retaining member
defines that a blade will extend from the elongate handle is herein
referred to as the exit angle. Where the blade retaining member is
an elongate member, the exit angle is the angle between the centre
line of the elongate handle and the centre line of the elongate
member where it extends from the elongate handle. The exit angle is
an interior angle during normal operation. In some embodiments, the
exit angle may exceed 180 degrees in a non-operating mode.
[0022] It may be that the blade retaining member is selectively
deployable in a plurality of configurations in which the exit angle
is restricted at least to the extent of limiting the maximum exit
angle, wherein the maximum exit angle is different in each of the
plurality of configurations. As with traditional Macintosh
laryngoscopes it may in some circumstances be sufficient to
restrict rotational movement of the blade retaining member only to
the extent of limiting the maximum exit angle, with the maximum
exit angle being different in the different configurations.
[0023] It may be that the blade retaining member is selectively
fixable in one, or a plurality of positions, that is to say it
might be possible to selectively fix the blade retaining member at
a particular exit angle or it may be possible to selectively fix
the blade retaining member at any of a plurality of different exit
angles. The plurality of different exit angles may be discrete or
continuous. It may be that blade retaining member can be
selectively fixed at one or more discrete exit angles and also be
selectively fixed at a range of different exit angles which may or
may not overlap with the one or more discrete exit angles.
[0024] By allowing a blade to be selectively deployable in a
plurality of configurations or selectively fixable in one or more
positions, additional flexibility is provided to an operator. For
example, where a laryngoscopy procedure requires the use of a blade
with a relatively high curvature, such as an indirect view blade,
the exit angle can be greater than would be employed with a blade
of relatively low curvature, such as a direct view blade. This may
for example, avoid the handle of a device using a more highly
curved blade from coming into contact with the patient's chest.
[0025] The exit angle at which the blade retaining member is
selectively fixed, or the maximum exit angle to which the blade
retaining member is limited may be selected by a user before a
blade is fitted. Nevertheless, the said exit angle or maximum exit
angle may be selected during a laryngoscopy procedure (before force
is applied) or changed during a laryngoscopy procedure. A manually
operable control may be provided to change the exit angle at which
the blade retaining member is fixed, or the maximum exit angle to
which it is limited. The manually operable control may for example,
comprise a manually operable release mechanism or an automatically
operable release mechanism.
[0026] The manually operable control may comprise a gear or a
plurality of gears. In embodiments where the manually operable
control comprises a plurality of gears, the plurality of gears may
be arranged in a gear train, a worm drive or a planetary
arrangement. The manually operable control may provide a resistance
to movement of the blade retaining member to provide tactile
feedback to the user, assuring the user that the blade retaining
member is movable between the secured and locked working positions
in a controlled manner.
[0027] The manually operable control may comprise a drum mechanism,
whereby the drum is fixed to the blade retaining member and mounted
to the elongate handle, such that rotation of the drum is coupled
to pivoting of the blade retaining member. The manually operable
control may comprise a locking mechanism operable to lock the
position of the drum.
[0028] The locking mechanism may be manually operated by the user
by the pushing of a button or pulling a catch, for example. The
locking mechanism may be operated via a touch screen and may
comprise a solenoid or a motor, for example.
[0029] The locking mechanism may comprise a locking pin and the
drum may comprise a plurality of apertures configured to receive
the locking pin, such that the drum may be locked in a plurality of
positions corresponding to a plurality of exit angles of the blade
retaining member. The plurality of apertures may comprise one or
more apertures configured to receive the locking pin such that it
is necessary for the user to retract the locking pin from the said
aperture before the drum and blade retaining member can be rotated.
The plurality of apertures may comprise one or more apertures
configured to receive the locking pin such that the user may rotate
the drum and blade retaining member without actively retracting the
locking pin.
[0030] A manually operable control comprising a drum mechanism may
be enclosed within the elongate handle to allow the elongate handle
to be sealed and the outer surface to be smooth such that the
elongate handle may be readily cleaned or sterilised between uses.
In addition, the drum mechanism is able to sustain the torsional
forces that are required for difficult laryngoscopy procedures.
[0031] The manually operable control may comprise a pair of
interlocking plates. Each of the interlocking plates may comprise a
series of teeth to reversibly engage the series of teeth of the
other plate. The interlocking plates may be rotated relative to
each other about a common axis when one of the interlocking plates
are moved along the common axis such that the interlocking plates
disengage from each other. The blade retaining member may be
coupled to one of the interlocking plates, such that rotation of
that interlocking plate results in pivoting motion of the blade
retaining member. In this way, the blade retaining member may be
moved from a first working position (e.g. a position suitable for
use with a direct view blade) to a second working position (e.g. a
position suitable for sue with an indirect blade), or from a first
working position to a storage position, for example.
[0032] The manually operable control may comprise a locking
mechanism. The locking mechanism may prevent the interlocking
plates disengaging. The locking mechanism may comprise a locking
pin. The locking pin may be biased towards a position that prevents
the interlocking plates disengaging. The locking pin may be
retracted manually using a button mechanism, such as a button, for
example. The locking pin may be retracted automatically using a
solenoid or motor, for example. The pin may be retracted
automatically using a touch screen.
[0033] A manually operable control comprising interlocking plates
separates the positional mechanism from the locking mechanism,
allowing each to be engineered separately, and may be enclosed
within the elongate handle, allowing the elongate handle to be
fully sealed for ease of cleaning and sterilisation between
procedures.
[0034] The laryngoscope may comprise one or more actuators (e.g.
one or more servo motors or stepper motors) to change the exit
angle at which the blade retaining member is selectively fixed, or
the maximum exit angle to which the blade retaining member is
limited. The one or more actuators might be activated by a user
operable control (e.g. a button or icon on a touch screen) or
automatically, for example responsive to detection of a particular
blade type.
[0035] By allowing a blade to be used at a plurality of exit
angles, it becomes possible for blades with different curvatures to
be used with the same laryngoscope while still extending correctly
between a patient's teeth through the oropharynx to their larynx,
and without unwanted contact with the patient's chest.
[0036] For example, the blade retaining member may be selectively
fixable in a first position having a first exit angle (or having
the maximum exit angle fixed at a first exit angle) suitable for
use with a first blade having an inferior surface with a first
curvature (for example a direct view blade), and also be
selectively fixable at a second position having a second exit angle
(or have the maximum exit angle fixed at a second exit angle),
which is greater than the first exit angle, suitable for use with a
second blade having an inferior surface with a second curvature
which is greater than the first curvature (for example an indirect
view blade).
[0037] It may be that the exit angle (or maximum exit angle as
appropriate) is between 120 and 140 degrees in the first position.
It may be that the exit angle (or maximum exit angle as
appropriate) is between 125 and 135 degrees in the first position.
Most preferably, thie exit angle (or maximum exit angle as
appropriate) is approximately 130 degrees in the first
position.
[0038] It may be that the exit angle (or maximum exit angle as
appropriate) is between 140 and 180 degrees in the second position.
It may be that the exit angle (or maximum exit angle as
appropriate) is between 150 and 170 degrees in the second position.
It may be that the exit angle (or maximum exit angle as
appropriate) is between 155 and 165 degrees in the second
position.
[0039] It may be that the difference between the exit angle (or
maximum exit angle, as appropriate) in the first and second
positions is at least 10 degrees, or at least 20 degrees.
[0040] It may be that the said first position is a discrete
position at which the blade retaining formation may be fixed. It
may be that the said second position is a discrete position at
which the blade retaining formation may be fixed.
[0041] It may be that the exit angle (or maximum exit angle as
appropriate) is adjustable to at least, or greater than 180
degrees. It may be that the exit angle (or maximum exit angle as
appropriate) cannot be fixed beyond a maximum fixed exit angle. The
maximum fixed exit angle may be the said exit angle or maximum exit
angle in the second position.
[0042] Where the blade retaining member comprises a said elongate
member, the elongate member may function as a strengthening
element. For example, it may include an elongate strengthening
member. The elongate member may therefore be formed from a strong
engineered plastics material or metal, or include an elongate
strengthening member formed from a strong engineered plastics
material or metal.
[0043] The advantage of a blade retaining member in the form of an
elongate member that functions as a strengthening element that is
inserted into the channel of a blade, is that the blades used do
not need to be as strong or resilient to deformation than would
otherwise be the case. Therefore, the blade may be lighter and/or
have a smaller cross-sectional area, making insertion into a
patient's oral cavity easier, and the blades cheaper to
manufacture.
[0044] The elongate handle and the elongate member may lie in a
common plane. The axis of the elongate handle and the plane of the
elongate member may be parallel, the plane of the elongate handle
laterally offset from the plane of the elongate member.
[0045] The blade retaining member may have a storage position
wherein the blade retaining member is oriented to direct a blade
such that the tip of a retained blade extends along, or is
partially or fully recessed within the elongate handle. In this
position, the exit angle may, for example, be at most 50
degrees.
[0046] Typically, the blade retaining member does not retain a
blade when in the storage position. It may be that, when in the
storage position, the distance between the distal end of the blade
retaining member and the elongate handle is less than 5 cm, or less
1 cm. The distal end of the blade retaining member may abut the
elongate handle when in the storage position. The distal end of the
blade retaining member may be partially or fully recessed within
the elongate handle.
[0047] In embodiments where the blade retaining member retains a
blade when in the storage position, the distance between the distal
tip of the retained blade and the elongate handle may be less than
5 cm, or less than 1 cm. The distal tip of the retained blade may
abut the elongate handle when in the storage position. The distal
end of the retained blade may be partially or fully recessed within
the elongate handle.
[0048] Thus, the laryngoscope body occupies a more compact volume
that is easier to store within a container, for example.
[0049] A biasing mechanism may be provided to bias the exit angle
between the blade retaining member and the handle. The blade
retaining member may be biased to reduce the exit angle. The blade
retaining member may be biased to increase the exit angle. The
sense of biasing may change with exit angle, for example, the blade
retaining member may be biased to reduce the exit angle below a
fixed threshold but biased to increase the exit angle above a
second threshold angle, so that it can be left at the maximum
possible exit angle. Biasing can be advantageous firstly to assist
in locating the blade retaining member at certain positions and
also in that a user would typically prefer the feeling of operating
a blade retaining member which is subject to a biasing force rather
than freely moving, which can feel insubstantial.
[0050] The blade retaining member may be selectively fixable in
two, or three or more discrete positions in which there is a
different exit angle between the elongate handle and a blade
retained on the blade retaining member.
[0051] The blade retaining member may be biased by one or more
resilient elements, for example one or more springs.
[0052] The laryngoscope may comprise a resilient cover which
extends at least over the flexible junction between the handle and
the blade retaining member. The resilient cover may take the form
of a skin. The resilient cover may extend over the whole of the
handle and the blade retaining member. This resilient cover can be
useful to prevent contamination in the joint region between the
handle and the blade retaining member. The resilient cover may act
to bias the blade retaining member, for example to a particular
exit angle or range of exit angles, by resisting movement away from
the particular exit angle or range of exit angles.
[0053] When the blade retaining member is fixed in a position the
blade retaining member may be held in place by a locking element,
for example a pin. The blade retaining member may be released from
the locking element by a release mechanism, for example a button or
other user interface element, such as a region of a touch screen
(e.g. an icon). The release mechanism may be manually operable, for
example it may be located on the elongate handle such that it may
be operated by the user, by depression by their thumb, for example,
during use. The release mechanism may comprise an automatic
mechanism, for example a servo motor actuatable by a user pressing
a button, or operating a touch screen.
[0054] Preferably, the blade retaining member is pivotally mounted
to the elongate handle. The laryngoscope body may comprise a pivot
about which the blade retaining member may pivot relative to the
elongate handle. Accordingly, the blade retaining member may be
pivotally moveable from a first position to a second position, or
from a first position to a storage position, for example.
[0055] The laryngoscope body may comprise a blade recognition
element operable to recognise which type of blade is retained on
the blade retaining member. The blade recognition element may be
located within the elongate handle of the laryngoscope body. The
blade recognition element may be located within the blade retaining
member. The blade recognition element may be located within the
elongate handle and the blade retaining member. For example, the
blade recognition element may be operable to determine whether a
blade retained on the blade retaining member is a direct view blade
(such as a Macintosh blade) or whether the blade retained on the
blade is an indirect view blade.
[0056] Blades with a different shape, or blades with equivalent
shapes but different sizes, may have different indicators, e.g.
different signs, be made of different colours, or have optical or
electronically readable devices (e.g. RFID tags) storing different
identifier data, or have different packaging.
[0057] In embodiments where the blades comprise electronically
readable devices, such as RFID tags, for example, the blade
recognition element may comprise an aerial and a processor operable
to interpret signals received by the aerial and to output a signal
dependent on the signal received by the aerial. Thus, the blade
recognition element may be an RFID receiver. The aerial may be
located within the blade retaining member. The processor may be
located within the elongate handle.
[0058] Typically, the curvature of a given blade determines whether
it is suitable for use with the laryngoscope body when the blade
retaining member is in a given position. By curvature of the blade
we refer to the change in orientation between the proximal and
distal ends of the blade. For example, a blade of a first curvature
(for example, a standard blade such as a Macintosh-type blade)
suitable for use with the laryngoscope body when the blade
retaining member is in the first position may not be suitable, or
may be less suitable, for use when the blade retaining member is in
the second position. Typically, the curvature of a direct view
blade is such that when retained by the blade retaining member in
the first position, the distal end of the blade (the end of the
blade furthest from the elongate handle) is far enough from the
elongate handle that the said elongate handle will not contact a
patient's chest during a standard laryngoscopy procedure.
[0059] Blades with a higher curvature, such as indirect view
blades, for example, require a larger separation between the
elongate handle and the distal end of the blade to ensure that the
elongate handle does not contact a patient's chest during an
laryngoscopy procedure. When such a blade is retained by the blade
retaining member in the second position, the greater exit angle
ensures that the distal end of the blade and the elongate handle
are sufficiently separated that the elongate handle does not
contact a patient's chest during a laryngoscopy procedure.
Therefore, such blades are suitable for use when the blade
retaining member is in the second position, and not suitable for
use when the blade retaining member is in the first position.
[0060] Therefore, the provision of a blade recognition element
ensures that the correct blade type is used in the correct position
of the blade retaining member.
[0061] The blade recognition element may comprise a Radio Frequency
Identification (RFID) reader and the blades to be used with the
laryngoscope body may comprise RFID tags. The RFID reader may be
operable to read data from a given blade retained on the blade
retaining member and to determine whether the correct blade is
retained for the current position of the blade retaining member.
The laryngoscope body may be configured to (e.g. programmed to)
inform the user of the type of the blade retained on the blade
retaining member dependent on the determination made by the RFID
reader. The type of blade communicated to the user may be chosen
from a plurality of types of blade. The plurality of types of
blades may comprise direct view blades. The plurality of types may
comprise indirect view blades. The plurality of types may include
at least two types of blade which have different curvatures which
affect how they are operated and are not different sizes of the
same type of blades. This is important as blades with significantly
different curvatures (e.g. direct view and indirect view blades)
are operated quite differently and it is important that a user is
aware of the type of blade and to follow the correct procedure.
[0062] The laryngoscope body may inform the user as to the
procedures suitable for the blade retained on the blade retaining
member. The laryngoscope body may inform the user as to whether the
blade retained by the blade retaining member is suitable for use in
the current position of the blade retaining member. The
laryngoscope body may be configured to (e.g. programmed to) convey
information to the user via an aural indication, such as an audible
alarm when a blade is mounted onto the blade retaining member when
the blade retaining member is in the wrong position for that blade,
or the type of blade that is mounted onto the blade retaining
member, for example. The laryngoscope body may be configured to
(e.g. programmed to) convey information to the user via a visual
indication. The visual indication may be from one or more light
sources, such as light emitting diodes (LEDs). The visual
indication may be from a screen. The screen may show the user a
video sequence indicating the type of procedure suitable for the
blade retained by the blade retaining member, for example.
[0063] In the event of the incorrect blade being used for the
current position of the blade retaining member, the laryngoscope
body may be configured to (e.g. programmed to) warn the user, for
example by emitting a sound from a speaker or light from a light
source, such as a light emitting diode (LED) or displaying a
suitable indication on a screen. In such an event, the laryngoscope
body may prevent the user from using the blade by deactivating a
screen or light source of the laryngoscope, where the laryngoscope
is a video laryngoscope, for example.
[0064] The blade recognition element may comprise a cooperating
formation and the blades to be used may comprise complementary
formations such that the cooperating formation is operable to
receive the complimentary formation of one or more correct blades
retained on the blade retaining formation or to block the
complementary formation of one or more incorrect blades. For
example, the cooperating formation may require a blade suitable for
use when retained in the first position to comprise a first
complementary formation at the blades proximal end, and a blade
suitable for use when retained in the second position to comprise a
second complementary formation at the blades proximal end.
[0065] The blade recognition element may comprise a blocking
formation that prevents a blade being retained on the blade
retaining member when the blade retaining member is in the wrong
position for that particular blade. For example, a blade suitable
for use in the second position may be prevented from being retained
on the blade retaining member in the first position by the blocking
formation.
[0066] In this way, a blade suitable for use in the first position
would not be able to be retained by the blade retaining member
until the blade retaining member is fixed in the first position, or
a blade suitable for use in the second position would not be able
to be retained by the blade retaining member until the blade
retaining member is fixed in the second position, for example.
[0067] Accordingly, it would become impossible or difficult to use
the incorrect blade for a given position of the blade retaining
member, which ensures that the correct blade is used in the correct
position for the correct procedure.
[0068] Typically, in embodiments comprising an elongate member, the
elongate member comprises a proximal end and a distal end, the
proximal end adjoining the elongate member to the laryngoscope body
and the distal end at the point of the elongate member furthest
from the elongate handle.
[0069] The laryngoscope body may comprise a display screen
assembly. The display screen assembly may extend from the elongate
handle. The display screen assembly may be at least partially
embedded within the elongate handle. For example, the display
screen assembly may be generally oblong (and typically has a major
dimension parallel to the length of the handle). One side of the
display screen assembly may abut or extend from the elongate
handle. In embodiments where the blade retaining member comprises
an elongate member, the display screen assembly may extend from the
elongate handle in a plane normal to the common plane within which
the elongate handle and the elongate member lie.
[0070] The display screen assembly may comprise a display screen.
Typically, the display screen has an inner edge and an outer edge,
and the inner edge is within the lateral extent of the elongate
handle and the outer edge extends beyond the lateral extent of the
elongate handle.
[0071] The display screen assembly may have a first end and a
second end, the second end being closer to the blade retaining
member than the first end; the laryngoscope body may comprise a
grip portion extending from the second end of the display screen
assembly to the proximal end of the blade retaining member; wherein
the distance between the second end and the proximal end is between
3 cm and 9 cm. Accordingly, the resulting laryngoscope body is
compact and can be comfortably held by the user.
[0072] The display screen may be a touch screen such that the image
received and displayed by the display screen assembly may be
manipulated by the user's fingers or thumb whilst being viewed. The
brightness or contrast of the image may be altered by pressing or
touching controls displayed on the screen, for example.
[0073] In this way, the user may operate the touch screen with
their thumb, for example, without needing to adjust or change the
user's gripping position on the grip portion of the laryngoscope
body. Accordingly, the touch screen can be easily and quickly
operated during a procedure without the user compromising their
grip on the laryngoscope body.
[0074] In embodiments where the laryngoscope body comprises
actuators to change the exit angle of the blade retaining member,
the display screen may be used to select or change the exit angle
(or the maximum exit angle, as appropriate) of the blade retaining
member.
[0075] The display screen assembly may have a thickness of less
than 5 mm to avoid bulk and to keep the centre of graining towards
the blade. The display screen assembly may be located on the front
(user facing) surface of the body.
[0076] The display screen assembly may be integral to the body, or
may be connected to the body. In embodiments comprising an elongate
blade retaining member, the display screen assembly may be
pivotable about an axis extending generally perpendicular to a
median plane within which the elongate handle and the elongate
member lie. The display screen may be pivotable about a pivot
extending from the body, generally perpendicular to the median
plane. The display screen may be flexible.
[0077] The display screen is advantageously large, so as to provide
the most detailed images to the user. The display screen may
comprise all or the majority of the face of the display screen
assembly viewable to a user of the laryngoscope during a medical
procedure. The display screen preferably has a diagonal dimension
greater than 2.5 cm (1 inches), of greater than 5 cm (2 inches), or
at least 6 cm (2.4 inches) or at least 8 cm (3.1 inches).
Preferably the diagonal dimension is less than 13 cm (5 inches),
less than 12 cm (4.7 inches) or less than 10 cm (3.9 inches). In
some embodiments the diagonal dimensions is between 8.5-9.0 cm
(around 3.5 inches) or 10.0-11.0 cm (around 4.3 inches).
[0078] The aspect ratio is typically between 1:1 (height:width) and
2:1 (height:width), more typically between 1.2:1 and 1.6:1, for
example around 1.4:1. The surface area is typically at least 15
cm.sup.2 and preferably at least 20 cm.sup.2. The surface area is
typically less than 100 cm.sup.2 and preferably less than 60
cm.sup.2 or less than 40 cm.sup.2.
[0079] Another advantage of the variable exit angle is that this
can enable a user to vary the angle between the blade and the
screen by adjusting the screen orientation or the exit angle in use
in order to obtain a better view of the screen.
[0080] Preferably, the blade retaining member comprises a camera.
The camera may be located at the distal end of the blade retaining
member. In use, the blade may be situated such that a view of the
larynx of the patient may be obtained via the camera. In
embodiments comprising a display screen assembly, the camera may be
connected to the display screen assembly such that an image of the
patient's larynx obtained by the camera may be displayed on the
display screen assembly.
[0081] The blade retaining member may comprise a light source. The
light source may be located adjacent to the camera such that light
emitted by the light source reflects from a target to be detected
by the camera.
[0082] In embodiments comprising a camera, a light source and/or a
display screen assembly, the elongate handle may comprise a power
source, such as a battery, to provide power to the camera, light
source and/or display screen assembly.
[0083] The laryngoscope body may comprise a force meter operable to
measure the force applied by the operator to the blade retaining
member via the blade during a laryngoscopy procedure. The force
meter may warn the operator if the force applied to the blade
exceeds a pre-set limit. The warning may be the emission of a
sound, or the lighting of a light source, such as a light emitting
diode (LED), or the display of a warning on a screen, for example.
The force meter may release the position of the blade retaining
member when a second pre-set force is exceeded to prevent the blade
causing damage or further damage to the patient.
[0084] The laryngoscope body may be configured to indicate to a
user whether a blade retained by the blade retaining member is
suitable for use in the current position of the blade retaining
member upon recognition of the retained blade by the blade
recognition element.
[0085] The laryngoscope body may be configured to prevent use of a
retained blade that is not suitable for use in the current position
of the blade retaining member upon recognition of the retained
blade by the blade recognition element.
[0086] The blade retaining member may be movable automatically from
a first position to a second position automatically.
[0087] According to a second aspect of the invention there is
provided a laryngoscope blade comprising a mounting element for
mounting the laryngoscope blade to a blade retaining member and an
electronically readable storage medium operable to store
information relating to the type of the laryngoscope blade wherein
the electronically readable storage medium is readable by the blade
recognition element of the laryngoscope body according to the first
aspect of the invention.
[0088] The electronically readable storage medium may be a radio
frequency identification tag. The electronically readable storage
medium may be random access memory (RAM). The electronically
readable storage medium may be read-only memory (ROM).
[0089] The information relating to the type of the laryngoscope
blade may be indicative of to the curvature of the inferior surface
of the laryngoscope blade. The information relating to the type of
the laryngoscope blade may be indicative of the size of the
laryngoscope blade.
[0090] Preferably, the mounting element is an elongate channel. The
elongate channel typically cooperates with the mounting
element.
[0091] The invention extends in a third aspect to a kit of parts
comprising a laryngoscope body according to the first aspect, and a
plurality of laryngoscope blades according to the second aspect,
wherein the plurality of laryngoscope blades comprises at least one
laryngoscope blade having an inferior surface with a first
curvature, and at least one laryngoscope blade having an inferior
surface with a second curvature which is different to the first
curvature.
[0092] The at least one laryngoscope blade having an inferior
surface with a first curvature may be a direct view blade (i.e.
suitable for use to directly view the larynx of a patient). The at
least one laryngoscope blade having an inferior surface with a
second curvature which is different to the first curvature may be
an indirect view blade (i.e. suitable for use with difficult
airways to indirectly view the larynx of a patient). The at least
one laryngoscope blade having an inferior surface with a second
curvature may not be suitable for use to directly view the larynx
of a patient.
[0093] The first curvature may differ from the second curvature
(each defined as the change in orientation between the proximal and
distal ends of the blade) by at least 10 degrees.
[0094] According to a fourth aspect of the invention there is
provided a laryngoscope comprising a laryngoscope body according to
the first aspect of the invention, wherein the blade retaining
member retains a blade, the blade extending away from the elongate
handle, wherein the orientation of the blade retaining member is
variable to vary the exit angle between the blade retaining member
and the handle.
[0095] The invention extends in a fifth aspect to apparatus
comprising a laryngoscope body according to the first aspect of the
invention and a plurality of blades, each blade in the plurality of
blades comprising a mounting element for mounting the laryngoscope
blade to the blade retaining member, the plurality of blades
comprising a first blade having an inferior surface with a first
curvature (for example, a direct view blade), and a second blade
having an inferior surface with a second curvature which is
different to the first curvature (for example an indirect view
blade). The apparatus may be provided in the form of a kit.
[0096] Preferably, the blade retaining member comprises an elongate
member for slidably retaining a blade having a cooperating channel.
The elongate member may be fixable at a plurality of angles
relative to the elongate handle. Further optional features of the
elongate member are discussed above in relation to the first four
aspects of the invention. For example, the elongate member may
function as a strengthening element.
[0097] Preferably, each of the blades within the plurality of
blades comprise a said channel to receive the blade retaining
member; the plurality of blades comprises two blades and the
inferior surface of each of the two blades has a different
curvature adjacent to the channel of each blade. By curvature
adjacent to the channel of the blade, we refer to the change in
orientation of the inferior surface between the distal and proximal
ends of the channel. For example, a first blade within the
plurality of blades may have a first curvature, and a second blade
within the plurality of blades may have a second curvature. The
first curvature may be greater than the second curvature or vice
versa. Typically, the curvature of the elongate member (and the
channel of each blade) is the same as the curvature of the inferior
surface of the blade with the most curved inferior surface adjacent
the channel.
[0098] Preferably, the channel of each blade within the plurality
of blades has the same curvature, and corresponds to the curvature
of the blade retaining member of the laryngoscope body.
[0099] However, it may be that two blades in the plurality of
blades have channels with different cross-sections. It may be that
the external shape of two blades in the plurality of blades differs
by more than scale.
[0100] Preferably, each blade within the plurality of blades
comprises a lifter portion at the distal end of the blade; the
plurality of blades comprises a first blade and a second blade
wherein the first and second blades have lifter portions extending
in different orientations.
[0101] In this application, the term lifter portion refers to that
portion of the blade that extends from the distal tip of the blade
to the distal end of the channel. Typically, a first blade having a
greater curvature adjacent to the channel of the blade than a
second blade will have a litter portion oriented at a greater angle
from the tangent of the end of the channel.
[0102] Alternatively, a first blade may have the same curvature
adjacent to the channel of the blade as a second blade, but the
lifter portion of the first blade extend at a different angle than
that of the second blade.
[0103] The curvature of the inferior surface adjacent to the
channel of each blade within the plurality of blades may vary
between each blade.
[0104] Preferably, the blade retaining member of the laryngoscope
body has a curvature equal to the curvature of the inferior surface
of the blade with the greatest curvature within the plurality of
blades.
[0105] The apparatus may be a kit. The apparatus may be a storage
facility. The apparatus may be an operating theatre. The apparatus
may be a hospital.
[0106] According to an eighth aspect of the invention there is
provided a method of using a laryngoscope comprising the steps of;
[0107] providing a laryngoscope body according to the first aspect
of the invention, a first blade and a second blade; [0108] fixing
the blade retaining formation in a first position having a first
exit angle or deploying the blade retaining formation in a first
configuration in which the exit angle is limited to a first maximum
exit angle; [0109] mounting the first blade to the blade retaining
formation of the laryngoscope body; [0110] using the laryngoscope
body and first blade; [0111] demounting the first blade; [0112]
fixing the blade retaining formation in a second position having a
second exit angle which is different to the first exit angle, or
deploying the blade retaining formation in a second configuration
in which the exit angle is limited to a second maximum exit angle,
which is different to the first maximum exit angle; [0113] mounting
the second blade to the blade retaining formation; and using the
laryngoscope body and second blade.
[0114] The step of fixing the blade retaining formation in a first
position having a first exit angle or deploying the blade retaining
formation in a first configuration in which in which the exit angle
is limited to a first maximum exit angle, and the step of mounting
the first blade to the blade retaining formation may take place in
either order.
[0115] The step of fixing the blade retaining formation in a second
position having a second exit angle or deploying the blade
retaining formation in a second configuration in which in which the
exit angle is limited to a second maximum exit angle, and the step
of mounting the second blade to the blade retaining formation may
take place in either order.
[0116] Preferably, the curvature of the inferior surface of the
first blade adjacent to the channel of the blade is different to
the curvature of the inferior surface of the second blade adjacent
to the channel of the blade.
[0117] Preferably, the method comprises the step of choosing
between the first and second blade based upon the curvature of the
inferior surface adjacent to the channel of each blade.
[0118] Typically, laryngoscopes have a fixed blade or detachable
blades that are suitable for use with a particular laryngoscope.
For example, a first laryngoscope may be designed for use in
standard intubation procedures and standard blades, such as
Macintosh blades, are suitable for use with the first laryngoscope.
During the procedure it may become apparent that the patient's
airway is obstructed, and that it is necessary to use a blade with
a higher curvature such as an indirect view blade. Such blades are
generally not suitable for use with a standard laryngoscope, due to
the proximity of the distal tip of a mounted blade to the handle of
the standard laryngoscope. Therefore, a second laryngoscope is
required to use these blades with high curvature and the
laryngoscope must be changed during the procedure.
[0119] Changing the laryngoscope during an intubation procedure is
time consuming, the required second type of laryngoscope may not be
available and the need to have two laryngoscopes for a single
procedure is inefficient and expensive. Therefore, the provision
for a method of use of the laryngoscope body of the first aspect of
the invention where the same laryngoscope body can be used during a
procedure where an obstructed airway is discovered with either of
the two types of blade (direct and indirect view) is more
efficient, the equipment costs are lower and allows the procedure
to be carried out faster, potentially saving a patient's life.
[0120] The invention extends to a eighth aspect there is provided a
method of using a laryngoscope comprising the steps of: [0121]
providing a laryngoscope body according to the first aspect and a
blade configured to be retained by the blade retaining member;
[0122] fixing the blade retaining member of the laryngoscope body
in a first position having a first exit angle or deploying the
blade retaining member in a first configuration having a first
maximum exit angle; [0123] mounting the blade to the blade
retaining member of the laryngoscope body; [0124] inserting the
blade into the oral cavity of a patient; [0125] fixing the blade
retaining member of the laryngoscope body to a second position
having a second exit angle which is different to the first exit
angle or deploying the blade retaining member in a second
configuration having a second maximum exit angle; and viewing the
oral cavity, or a portion of the oral cavity of the patient.
[0126] During an intubation procedure, it may become apparent that
it would be preferable to use an indirect view blade which is more
curved than a direct view blade. Using laryngoscopes known in the
art, it would be necessary to withdraw the inserted blade from the
patient's oral cavity, and use a second laryngoscope adapted for
use in these situations. This is time consuming and requires a
second laryngoscope to be present for any given intubation
procedure.
[0127] Therefore, the ability to adjust the position of the blade
retaining member from a first position to a second position, whilst
the blade mounted onto the blade retaining member is inserted into
a patient's oral cavity allows the intubation procedure to be
carried out much more efficiently and with a lower equipment cost
than is possible with laryngoscopes in the art.
[0128] Optional features discussed in relation to any aspect of the
invention are optional features of each aspect of the
invention.
DESCRIPTION OF THE DRAWINGS
[0129] An example embodiment of the present invention will now be
illustrated with reference to the following Figures in which:
[0130] FIG. 1 is a side view of a laryngoscope body with a blade
having a first curvature, and a side view of a laryngoscope body
with a blade having a second curvature;
[0131] FIG. 2 is a side view of a laryngoscope body where the blade
retaining member is in a first position and a view of a
laryngoscope body where the blade retaining member is in a second
position without (A) and with (B) suitable blades retained;
[0132] FIG. 3 is a side view of a laryngoscope body showing the
change in angle of the proximal and distal ends of a retained blade
in the first and second positions;
[0133] FIG. 4 is a perspective view of a series of laryngoscope
bodies having a blade retaining member in a first position, a
second position, a further position in which the blade cannot be
fixed and a storage position;
[0134] FIG. 5 is an exploded perspective view of a laryngoscope
body showing a fixing mechanism for a blade retaining member having
two positions in which the blade can be fixed;
[0135] FIG. 6 is a section view of the fixing mechanism showing how
the blade retaining member is moved from the second position to the
first position;
[0136] FIG. 7 is an exploded perspective view of a laryngoscope
body showing a manually operable control mechanism for a blade
retaining member having four positions in which the blade can be
fixed;
[0137] FIG. 8 is series of perspective views of the fixing
mechanism of FIG. 7 showing the positions in which the blade
retaining member may be fixed;
[0138] FIG. 9 is an exploded perspective view of a laryngoscope
body showing a manual operable control interlocking plate
mechanism;
[0139] FIG. 10 is an illustration of how the position of the blade
retaining member of FIG. 9 may be altered; and
[0140] FIG. 11 is a perspective view showing the available range of
movement of the blade retaining member relative to the laryngoscope
body in example embodiments.
DETAILED DESCRIPTION OF AN EXAMPLE EMBODIMENT
[0141] With reference to FIGS. 1 to 11 a laryngoscope body 1
comprises a handle 2 (functioning as the elongate handle) and a
blade retaining member 4 pivotally mounted to the handle. The
handle has a first end 6 and a second end 8 and comprises a display
screen 10 adjacent to the first end (acting as a display screen
assembly), an adjuster 12 adjacent to the second end, and a battery
14.
[0142] The adjuster comprises a release button 16, four guides (not
shown) that define two discrete positions 20a, 20b in which the
blade retaining member can be fixed, a position 21 in which the
blade retaining member cannot be fixed and a storage position 22
where blade retaining member can be fixed, and a spring (acting as
a resilient element). In the first position, the blade retaining
member is fixed at an exit angle of 135.degree.relative to the
handle. In the second position, the blade retaining member is fixed
at an exit angle of 160.degree.relative to the handle. The blade
retaining member can also be pivoted to extend to an exit angle of
up to 190.degree.relative to the handle but cannot be fixed in that
position. The storage position fixes the blade retaining member
such that it lies along the handle in a compact form suitable for
storage, with an exit angle of around 30 to 40.degree..
[0143] The four guides are defined by a series of partitions, each
guide separated from the adjacent guide by a partition. For
example, the first position is separated from the storage position
by a first partition and from the second position by a second
partition. The partitions may be lowered when the release button is
depressed such that the blade retaining member may be pivoted
between a first position to a second position (either positions or
the storage position).
[0144] The spring biases the blade retaining member from the
maximum possible exit angle towards the second position, and from
the storage position towards the first position.
[0145] The blade retaining member is an elongate tube of constant
curvature and extends from the handle at its proximal end 26 to its
distal end 28. The elongate tube of the blade retaining member is
sufficiently resilient to deformation in the plane of the curve of
the elongate tube that it acts as a strengthening element for any
blade mounted onto the blade retaining member. The blade retaining
member comprises a camera 30 and a light emitting diode 32 (LED,
acting as a light source) at its distal end, and a clip 34, to
ensure that a blade mounted onto the blade retaining member is
retained.
[0146] The curvature of blades retained on the blade retaining
member can be measured by the change in angle from the proximal end
of the blade (adjacent to the elongate handle when retained) to the
distal tip of the blade. For example, as shown in FIG. 3, the
change in angle for a direct view blade (defined by the angle
.phi.) is smaller than that for an indirect view blade (defined by
the angle .omega.), therefore indicating that a standard blade has
a lesser curvature than an indirect view blade. In this example,
the different blades all have inferior surfaces with different
curvatures in the region adjacent the blade retaining member, as
well as different overall curvatures.
[0147] As shown in FIG. 1, when the blade retaining member is in
the first position, the distal tip of a standard blade retained on
the blade retaining member is a distance x from the handle to the
laryngoscope body. If an indirect view blade is retained on the
blade retaining member in the first position, the distance between
the handle and the distal tip of the blade is reduced to y and may
result in the handle contacting the patient's chest during an
intubation procedure.
[0148] The display screen, LED and camera are powered by the
battery in the handle.
[0149] The handle further comprises a force meter adjacent to the
second end abutting the blade retaining member. The force meter
measures the force applied to the blade retaining member and sounds
an alarm or displays a warning when a threshold force is
exceeded.
[0150] When the laryngoscope body is not in use, the blade
retaining member is fixed in the storage position 35 resulting in a
more compact shape that may be stored with a more efficient use of
space.
[0151] Before use in an intubation procedure, the release button of
the adjuster is depressed and the blade retaining member is pivoted
from the storage position to the first position. For standard
intubation procedures, a Macintosh-type (standard) blade 36 having
a first curvature of the inferior surface comprising a channel 38
having the same internal curvature as the blade retaining member,
is mounted onto the blade retaining member by inserting the blade
retaining member into the channel of the blade and securing the
clip of the blade to the blade retaining member. The channel has a
transparent window at its distal end to allow the camera of the
blade retaining member to receive light. The distal tip of the
blade is oriented relative to the line of sight of the camera
within the blade retaining member at an angle .alpha..
[0152] The blade is then inserted into the oral cavity of a
patient, the LED, camera and display screen are turned on and the
operator attempts to obtain a view of the patient's larynx. In
standard procedures, the LED illuminates the patient's larynx and
the camera captures an image of the larynx and transmits the image
to the display screen on the handle of the laryngoscope body, to be
viewed by the operator. In the event of an obstruction in the
patient's oral cavity preventing a view of the larynx being readily
obtained, two alternate courses of action may be taken.
[0153] The first option is for the operator to apply a greater
pressure to the blade to force the obstructing anatomy to be
physically moved out of the line of sight. If the handle of the
laryngoscope body contacts the chest of the patient, the blade
retaining member can be moved from the first position to the second
position by depressing the release button and moving the blade
retaining member appropriately. The second position provides a
greater leverage for the operator to apply greater force. This
approach risks damaging the tissue of the oral cavity and teeth of
the patient, and could cause the blade to break in situ if the
blade has any manufacturing defects or if the applied force is too
great. Accordingly, the force meter within the handle of the
laryngoscope body warns the operator by sounding an alarm that the
force applied exceeds a predetermined threshold and that the
patient may be injured.
[0154] The second option is for the operator to remove the blade
from the oral cavity of the patient and to remove the blade from
the blade retaining member for disposal. The blade retaining member
is moved from the first position to the second position by
depression of the release button as outlined above. A second blade
is then fitted to the blade retaining member as per the first
blade, having a greater curvature of the inferior surface such as
an indirect view blade 40, but with a channel having the same
curvature as that of the blade retaining member. The distal tip of
the blade is oriented relative to the line of sight of the camera
within the blade retaining member by the angle .beta., where .beta.
is greater than .alpha.. The second blade is then inserted into the
patient's oral cavity and the combination of the greater curvature
of the blade and the greater exit angle in the second position
allow the operator to manipulate the patient's soft tissue in the
oral cavity to obtain a view of the patient's larynx.
[0155] Procedures where the patient's oral cavity is obstructed,
using instruments known in the art, typically require changing the
laryngoscope body itself, as each laryngoscope body is designed for
use with a single blade type. This can be a time consuming process
and relies on two laryngoscope bodies being available for any given
intubation procedure, increasing costs. However, the present
invention allows a single laryngoscope to be used with both a
Macintosh-like direct view blade and an indirect view blade
provided that a stock of both types of blade is maintained. Often a
practitioner will choose between the two blade types before the
procedure.
[0156] In an alternative embodiment the blade retaining member of
the laryngoscope body has two positions, a first position and a
second position, as shown in FIGS. 5 and 6, where the adjuster
mechanism 42 comprises a release button 44 connected to a plate 46
and a pivot 48, the plate is mounted on a spring 50 and comprises a
partition 52. The proximal end of the blade retaining member is
mounted onto the pivot such that motion about the pivot is
obstructed by the partition. Depression of the release button
pushes the plate down against the spring and thereby lowers the
partition such that the blade retaining member may freely pivot
about the partition from a first position to a second position, for
example.
[0157] The blade retaining member may be movable from the first
position to the second position by way of an automatic mechanism
comprising one or more servo motors. A locking pin may be
automatically retracted and then redeployed after movement. The
blade retaining member may move to a particular position responsive
to a user input, for example pressing a button or touching a user
interaction element (e.g. icon) on the screen.
[0158] The user may touch a user interaction element (e.g. icon) on
the screen using their thumb, whilst retaining their grip on the
elongate handle. Accordingly, the user may change or adjust the
exit angle of the blade retaining member without altering their
grip on the elongate handle, thereby minimising disruption of the
intubation.
[0159] In a further alternative embodiment, the blade retaining
member of the laryngoscope body has four positions, a storage
position 60, a first working position 62, a second working position
64 and a third working position 66, as shown in FIGS. 7 and 8. The
adjuster mechanism 70 comprises a socket 72, a drum 74 connected to
the proximal end of the blade retaining member by a hexagonal
engagement 76 and a locking pin 78. The drum comprises four
apertures around the circumference of the drum for receiving the
locking pin, corresponding to the four positions of the blade
retaining member.
[0160] The locking pin is biased towards the drum by a spring 80 to
retain the locking pin within an aperture once the locking pin has
been received by the said aperture. The locking pin may be
withdrawn 81 from an aperture by the user to move the blade
retaining member to a new position.
[0161] When the locking pin is received by two of the apertures
(82, 84) of the drum, the blade retaining member is locked into the
first or second working position and these positions for use with
direct view 82 and indirect view blades 84. The remaining two
apertures of the drum are shallower than those for use with direct
and indirect view blades to ensure that they do not fully engage
the locking pin, and correspond to the storage position 86 and the
third working position 88. As the said apertures do not fully
engage the locking pin, whilst the blade retaining member is held
in position, the user may manually move the blade retaining member
from the storage or flexed position without releasing the pin,
allowing the blade retaining member to be held initially in the
third working position, useful for initially introducing a blade
retained by the blade retaining member into the oral cavity of a
patient where the chest of the patient restrict laryngoscope
access. The locking pin then sits on the outer surface of the drum
until the blade retaining member is returned to either the third
working position or the second working position, whereupon the
locking pin is received by the appropriate aperture and the blade
retaining member position locked.
[0162] In a yet further alternative embodiment, the adjuster 90
connecting the blade retaining member to the elongate handle
comprises a first plate 92 connected to the blade retaining member
operable to move along an axis 94 within a limited range of
movement, a second plate 96 connected to the elongate handle
mounted within a socket 98 and coaxial with the first plate, a
spring 100 biasing the first plate towards the second plate along
the axis and a locking pin 102. The first plate and second plate
comprise a series of teeth 104, 106 configured to engage each other
when the first and second plates are in contact. The locking pin is
biased towards the axis by a spring 108 such that the position of
the first plate is fixed when the locking pin is engaged.
[0163] In a first position (e.g. a position suitable for use with a
direct view blade), the teeth of the first and second plates are
engaged and the locking pin is positioned to prevent the teeth of
the first plate from disengaging the teeth of the second plate,
such that the blade retaining member is locked in the first
position. If a user wishes to move the blade retaining member to a
second position (e.g. a position suitable for use with an indirect
view blade), the locking pin is retracted to allow the first plate
to be moved away from the second plate along the axis such that the
teeth of the first plate disengage the teeth of the second plate.
The first plate may then be rotated such that the blade retaining
member is moved into the desired second position. The first plate
is then allowed to move back towards the second plate, the teeth of
the first plate engage the teeth of the second plate and the
locking pin moves back to lock the position of the first plate.
[0164] In alternative embodiments the blades used for direct view
and indirect view intubation procedures have the same curvature of
the inferior surface adjacent to the channel of the blade but have
a lifter portion extending at different angles relative to the
tangent of the distal end of the channel, the direct view blade
having a smaller angle and the indirect view blade having a greater
angle.
[0165] Thus, a hospital may stock a kit of parts comprising a
single laryngoscope body and at least two blades with different
curvatures which are usable with the same laryngoscope, at least
two of which are to be used with a different exit angle of the
blade retaining member of the larnygoscope body.
[0166] In some embodiments, the blade retaining member is fixable
in a plurality of discrete positions. In other embodiments, the
blade retaining member can be fixed in a continuous range of
positions. In an example embodiment, the blade retaining member can
be fixed in first discrete position, at an exit angle of around
130-135.degree. to retain a direct view blade but can also be fixed
in a continuous range of positions, for example with an exit angle
of between 140.degree. and 180.degree. to retain an indirect view
blade. It may also be moved to an exit angle of up to 200.degree.
but not fixed beyond 180.degree.. In the example embodiment, the
blade retaining member is biased (e.g. by a first spring) to urge
it to an increasing exit angle when the exit angle is less than the
exit angle of the discrete position and biases to urge it to a
reduced exit angle when the exit angle is greater than the exit
angle of the discrete position (e.g. by the same spring or a second
spring). However, a further spring biases the blade retaining
member to increase the exit angle once the blade retaining member
passes a defined exit angle, for example 180.degree.. This means
that although it will not be fixed, the blade can be conveniently
located at the maximum possible exit angle 37 (which might for
example be in the range 200-245.degree.) and retained there by the
biasing.
[0167] Further variations and modifications fall within the scope
of the invention herein disclosed.
* * * * *